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073-340-005
7'3 - 3'4,0. 6 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION (IVR): (530) 538-4365 OFFICE: (530) 538-7541 FAX#: (530) 538-2140 ONLINE PERMIT/RENEWAL PAYMENTS: www.buttecounty.net\dds PROJECT INFORMATION Site Address: 5709 FORBESTOWN RD Owner: Permit No: B07-2260 APN: 073-340-005 BROOKS CAROL MARIE Issued Date: 05/23/2008 By KCG Permit type: RESIDENTIAL 211 CHESTER AVE Subtype: SFD-Custom/Model SAN FRANCISCO, CA 94132 Expiration Date: 05/23/2009 Description: NSF DWELLING(1426), COV(160), ( (415) 333-3780 Occupancy: R-3 Zoning: U 00 Contractor Applicant: Square Footage: BROOKS CAROL MARIE Building Garage Remdl/Addn 211 CHESTER AVE 1,426 SAN FRANCISCO, CA 94132 Other Porch/Patio Total (415) 333-3780 57 160 1,643 FEE INFORMATION DB R3 Dwelling -Custom, Model $1,595.58 DB R3 Dwelling -Custom, Model $1,003.51 DBEH Building Review Fee $75.70 DBFIRE Fire Inspection (SRA) $102.70 DBFIRE Fire Inspection (SRA) $102.70 DBFIRE SRA Fire Plan Review (S $102.70 DBOMSCF Fire Safe Standards Re $115.98 DBSMIP Residential $8.57 Total Charged: $3,107.44 Fees Paid: $3,107.44 Balance Due: $0.00 Receipt No: B7438 LICENSED CONTRACTOR'S DECLARATION OWNER / BUILDER DECLARATION Contractor (Name) State Contractors License No. / Class / Expires I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) is in full force and effect. of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects X 05/23/2008 the applicant to a civil penalty of not more than five hundred dollars [$5001; Please check one of the following: Contractor's Signature Date I, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL DO THE WORK AND THE STRUCTURE IS NOT INTENDED OR WORKERS' COMPENSATION DECLARATION OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of the property, who builds or improves thereon, and who does I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: the work himself or herself or through his or her own employees, provided that such improvements ❑I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR are not intended or offered for sale. If, however, the building or improvement is sold within one WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the year of completion, the owner -builder will have the burden of proof that he or she did not build or performance of the work for which this permit is issued. improve for the purpose of sale.). ❑I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by ❑ I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Professions Code: Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. The Contractor's License Law dows not apply to an owner of the property who builds or improves My Workers' Compansation insurance carrier and policy number are; thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractor's License Law.). Cartier. Policy Number: Exp. Date: (This section nee not be completed if the permit is or one undred ollars ($100) or less. CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ❑ 1 AM EXEMPT under Section B. & P.C. for this reason: ISSUED, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California, and agree that if I should become subject to the workers' X / 05/23/200$ compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those Owner's Signat a Date provisns. X 05/23/2008 1 hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building 67 Signature Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, construction, and with any and all conditions of permit. I agree to defend, indemnity, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE injury, including death, and property damage caused by, arising out of, or in any way connected with HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte ATTORNEY'S FEES. County to enter the above mentioned property for inspection purposes. I hereby certify that I am the pr erty owns or authorized act on th property owner's behalf. CONSTRUCTION LENDING AGENCY �� O (� 05/23/2008 I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for game of/Permittee, [SIGN] Print Date the performance of the work for which this permit is issued. (3097 civ. code) Owner El Contractor OR. Agent for Owner Agent for Contractor FILE COPY Lender's Address City State Zip BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 _ A FEE WILL BE REQUIRED AT TIME OF APPLICATION Website: www.buttecounty.net/dds **PLEASE PRINT CLEARLY** APPLICANT INFORMATION OWNER INFORMATION Last Name p 0 First Name a /z0 Mailing Address City city 5.Q v% CA--1 FravkLFa Zip 'ry%3Z Phone 3 3337 E-mail E-mail APPLICANT INFORMATION CONTRACTOR Name Owner k S d 2 V Address Zip City Fax State Zip Phone Fax E-mail Lic. # Class APPLICANT INFORMATION ARCHITECTIENGINEER Name City Address Zip City Fax State Zip Phone Fax E-mail State License Number APPLICANT INFORMATION Name Address City State Zip Phone Fax E-mail APPLICANT SIGNATURE X D PERMIT NO. BIN PROJECT LOCATION AN 0 13— 34o —'05 Property Address q F76 city CA - _.V -Vo WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK. Sq FT- Living jZ Garage D Open 'Cov 0'i ❑ Structure Built without Permits 571 ❑ Proposed Change of Occupancy (Note previous use): For office us2 inly: Zoning Flood Zone SRA Yes No Occ. Type Const. r TO ..oce- Contacts for School and Park Districts thru,Jan., ,-Durham Park & Recreation Closed Dec.24th thru 30th open 31St Closed Jan 1St "-Feather River_Recreation &'Park District--- __,Qlosed Dec .22"a thru Jan 2"a �_Earadise Par -k & Recreation Closed Dec 24`h_tff Jan 2nd""" Biggs Unified School District Closed Dec 21St thru Jan 4th Chico Unified School District Closed Dec. 21St, Dec. 24th, 25' and Dec. 31St. thru Jan.1 st CSA__ ham U ifie'_d`S_chool DistrictClosedTDec. 21 thru Jan. 7th - Gridley School District Closed Dec. 24 thru 25th and Jan. 1st Marysville Joint.School District Closed Dec 21 thru 25th and Dec. 31 thru Jan. 2"a Oroville Elementary School District Closed Dec. 21 thru 25th and Dec 31 St thru Jan. 1 st Oroville Union High School District Closed Dec. 24 thru 25 and Dec. 31St thru Jan. 1St. Paradise Unified School District Closed Dec. 24 thru Jan. 2nd Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-2140 Fax www.buttecounty.net/dds PERMIT APPLICATION DATA SHEET Reference Number: B07-2260 Date: 11/01/2007 Location: 5709 FORBESTOWN RD By: KCG Parcel Number: 073-340-005 Sub Type: SFD-Custom/Model Owner Name: BROOKS CAROL MARIE Phone: (415) 333-3780 Description: NSF DWELLE4G(1270), COV(160), OPEN(57)- REPLACEMENT The above permit application has the following Clearances required prior to permit issuance. Please contact each department indicated below regarding specific requirements pertaining to your permit application. Yes No DRAINAGE DISTRICTS ❑ ❑ Thermalito Irrigation District, 410 Grand Avenue, Oroville CA 95965 - (530) 533-0740 ❑ ❑ LOAPUD, 1960 Elgin Street, Oroville CA 95966 - (530) 533-2000 1■=■1 0=01 City of Chico, 545 Vallombrosa, Chico CA 95926 - (530) 895-4711 PARKS & RECREATION DISTRICTS Chico Area Recreation District, 545 Vallombrosa, Chico CA 95926 - (530) 895-4711 Durham Park & Recreation District, 9447 Midway, Durham CA 95938 - (530) 345-1921 Feather River Recreaction & Park District, 1200 Myers Street, Oroville CA 95966 - (530) 533-2011 Paradise Parks & Recreation, 6626 Skyway, Paradise CA 95969 - (530) 872-6393 SCHOOL DISTRICTS Biggs Unified School District, 300 B Street, Biggs CA 95917 - (530) 868-1281 Chico Unified School District, 1163 East 7th Street, Chico CA 95926 - (530) 891-3006 Durham Unified School District, 4920 Putney Drive, Durham CA 95938 - (530) 895-4675 Gridley School District, 429 Magnolia, Gridley CA 95948 - (530) 846-4723 Marysville School District, 1919 B Street, Marysville CA 95901 - (530) 741-6000 Oroville Elementary School District, 2795 Yard Street, Oroville CA 95966 - (530) 532-3000 Oroville Union High, 2211 Washington Ave, Oroville CA 95966 - (530) 538-2300 Ext:105 Paradise Unified School District, 6696 Clark Road, Paradise CA 95969 - (530) 872-6400 OTHER Recorded copy of Agricultural Acknowledgment Statement- See Attached Instructions City of Biggs Planning Department, 3016 Sixth Street Biggs CA 95917 - (530) 868-5447 Other: Other: Other: Signature of Property Owner: FILE Date: 11/01/2007 Part I Marysville Joint Unified School.bistrict BUTTE "Txl'ibit 3610 #1 MAY 1.9 2008 CERTIFICATION OF COMPLIANCE DEVELOPMENT SCHOOL DISTRICT DEVELOPMENT IMPACT FEES To be completed by applicant and taken to: Marysville Joint Unified School District 1919 B Street, Marysville, CA 95901 (530) 749-6114, Room 106 9 Property Owner's Name: 0 V C) f a,-) K S Owner's Address: a Qy 1(9 4, ( (J(' 15) 0 t1 �rr�r Project Address: .� I 0� I (� ^t � t1'�'_ ; Lif,J - 1 t z)y be t"-)'^ Parcel No: Q-7..`,':�,l"4 0 'COS Lot No: City or County: Building Dept: l J Gt:" f� �`� ,t i'1 ` Permit No: �� ' zD, -d- to TYPE OF CONSTRUCTION: Residential Construction Residential Reconstruction Commercial Construction X -V Single Family Dwelling_ Multiple Family Dwelling No. of Units Commercial Reconstruction Mobile Home I Total Number of Habitable Square Feet: �" 1J I LI , I f o'L"b"'C -- 1011 THIS CERTIFICATION COVERS ONLY THE AMOUNT OF SQUARE FOOTAGE INDICATED ABOVE. ANY ADDITIONS OR CORRECTIONS TO THE SQUARE FOOTAGE FOR THE PROJECT WILL REQUIRE AN AMENDMENT TO THE CERTIFI CATION OF COMPLIANCE. FALSIFICATION OF SQUARE FOOTAGE AND/OR TYPE OF CONSTRUCTION IS CAUSE FOR REVOCATION OF CERTIFICATION OF COMPLIANCE. ACCORDING TO GOVERNMENT CODE SECTION 66020 (d) 011 HAVE BEEN NOTIFIED THAT WITH THE IMPOSITION OF THIS FEE, THE 90 -DAY APPROVAL PERIOD IN WHICH I HAVE TO PROTEST THE FEE HAS BEGUN. Applicant's Name: n a 61 r Ca O k Date: -3 12-q LO f� Applicant's Signature. ,-, Cr --e -' L1r-- Part II TO BE COMPLETED BY BUILDING DEPARTMENT � �f� I Total Number of Habitable Square Feet CiiC� City of Marysville _, County of Yuba Signature (Y County of Butte Part III TO BE COMPLETED BY SCHOOL DISTRICT i . Certification of Compliance No. (Receipt No.): r %? C d� Fees Collected: No. of Square Feet x's $.42 for Commercial = $ No. of Square Feet �;iFKx's $4.31 for Residential = $ 16 t 13- 1p 1,... ;Exempt_from Fees: Reason: -`,IAS THE AUTHORIZED SCHOOL DISTRICT OFFICIAL, I HEREBY CERTIFY THAT THE REQUIREMENTS OF GOVERNMENT CODE SECTION 65995 HAVE BEEN COMPLIED WITH BY THE ABOVE SIGNED APPLICANT. Signature t zk/Y 1 '-k-,V 0 - White: - School District Yellow- - Applicant Pink: - Building Dept. Date ` ) _ 0 Ct OE SD:co 5112106 BUTTE COUNTY FEE SUMMARY 7 County Center Drive Oroville, CA 95965 Department of Development Services Phone (530) 538-7541 Fax (530) 538-2140 Permit Number: B07-2260 Job Address: 5709 FORBESTOWN RD Contractor: Printed: 11/01/2007 12:23 pm Fee Description Account Number Fee Amount Paid Date Pmt Amt DB R3 Dwelling -Custom, Model DBF DWLNG CSTM/MDL N Permit Fi 0010-440001-4210500-1010 $1,505.27 DBF DWLNG CSTM/MDL N Plan Rvv 0010-440001-4210500-1010 $1,003.51 11/01/2007 $1,003.51 DBEH Building Review Fee 0021-540013-4614901-1010 $75.70 11/01/2007 $75.70 DBFIRE Fire Inspection (SRA) 0100-450001-4617240-1010 $102.70 11/01/2007 $102.70 01004500014617240-1010 $102.70 DBOMSCF Fire Safe Standards Re 0010-440001-4210500-1010 $115.98 DBFIRE SRA Fire Plan Review (S 0100-450001-4617240-1010 $102.70 11/01/2007 $102.70 DBSMIP Residential 1001-0-280-1011298 $8.57 Printed By: Kourtni Graham 39017.13 $19284.61 Balance Due: $1,732.52 At the time of permit application, I was advised the above fees are required. prior to issuance of the permit. These71,7 y change ring the plan checking process. Signature:Date: 11/01/2007 Pursuant to Government code Section 66020, you are hereby notified those items listed above may have been imposed on your project. You have 90 days from the date of approval of the project or from the impostion of the above referenced items during which you may request a protest. The requirments for a protest are specified in Government Code Section 66020(a). AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE, CA 95965 COPY of Document Recorded 1 -Nov -2007 2007-0051453 Has not been compared vith original BUTTE COUNTY RECORDER AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8 of the Butte County Code required this acknowledgment.to be recorded.prior to issuance -of a building permit. The propertydescribed herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of this property may be subject to inconveniences or discomfort from the use of agricultural. chemicals, including, but not limited to herbicides, pesticides, and fertilizers;. and from the pursuit of agricultural. operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County. has established agricultural.purposes and residents within said zones and on adjacent property should .be prepared to. accept. such inconvenience or discomfort from normal, necessary farm operations. All that real property situate in the County: of Butte, State of California, described as follows: LOT 4, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "WAMENPOND.ESTATES, PHASE 1 WHICH MAP . WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON FEBRUARY 4,' 1981, IN BOOK 104 OF MAPS, AT:PAGES 72 AND 73. Date : ".. ... �._..L' PRTY OWNERS:::: State of California.• :..:: ) County of On �� J�`C�.� befoeeme,: personally appeared G'.a/Lo ��oo/%S personally .known to me (or:.proved to me•.on the -basis of'satisfactoryevidencey to be. the person(s).whose names):is/are subscribed to. the -within instrument and acknowledgedAo me that .he/she/they executed the same in his/her/their authorized capacity(ies), and that"by his/her/their signature(s).on the instrument, the person(s) or the entity upon behalf of which . the persons)' acted;.executed the.instrument. WITNESS. my hand and official seal: Rlr''HARC REUERSTEIN Si nature: . COMM. #1568619 g Seal: e NOTARY PUBLIC CALIFORNIA ` BUTTE COUNTY RO a ' My Comm. Expires April 13�2609 Butte County Department of Public Works J. MICHAEL CRUMP, DIRECTOR LAND DEVELOPMENT DIVISION Storm Water Managment Program 7 County Center Drive Oroville, CA 95965 (530) 538-7266 Telephone (530) 538-7171 Fax www.buttecounty.net/dds NNW 0 0 0 0 0 National Pollutant Discharge Elimination System (NPDES) Phase II Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgment (LESS THAN 1 ACRE 1 Reference Number: B07-2260 Location: 5709 FORBESTOWN RD Parcel Number: 073-340-005 Date: 11/01/2007 By: KCG Sub Type: SFD-Custom/Model Owner Name: BROOKS CAROL MARIE Phone: (415) 333-3780 Description: NSF DWELLING(1270), COV(160), OPEN(57)- REPLACEMENT By signing below, I the project owner/owners' agent, certify that this project WILL NOT DISTURB 1 acre or more of land and that I therefore, do not need to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board. Phased projects that contain multiple site buildouts of less than one acre but when combined with subsequent phases total more than one acre of disturbed soil will require a Construction Storm Water Permit from the state of California Regional Water Quality Board. I am aware that submitting false and/or inaccurate information or failure to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board for this project that disturbes one acre or more of land may result in revocation of grading and/or other permits or other santions provided by law. 0Signed: pi Title: r --- FILE Date: 11/01/2007 California Department�of Forestry and Fire Protection Butte County Fire Department Fire Prevention Bureau 176 Nelson Avenue, Oroville CA 95965 (530) 538-7888 Office, (530) 538-2105 Fax Reference Number: B07-2260 Date: 11/01/2007 Location: 5709 FORBESTOWN RD By: KCG Parcel Number: 073-340-005 Sub Type: SFD-Custom/Model Owner Name: BROOKS CAROL MARIE Phone: (415) 333-3780 Description: NSF DWELLING(1270), COV(160), OPEN(57)- REPLACEMENT To meet the requirements of Government Code section 51182 and Public Resource Code 4291, Butte County requires a pre -construction inspection to pro -actively provide the below building and site requirements to the property owner. Your property is located within the State Responsibility Area (SRA) of Butte County. SRA is required to meet the below requirements: ✓ Public Resources Code 4290 ✓ Public Resources Code 4291 ✓ California Building Code, Chapter 7A ✓ Butte County Improvement Standards Requirements prior to scheduling the pre -inspection: ✓ Full plan submittal to Butte County Development Services -Building Division ✓ Driveway and building pad must be identified on site ✓ Structure location must be staked out on the building site All development within the Requests for inspections shall be made a minimum of 72 hours in advance by calling the Fire Prevention Bureau's 24 hour inspection line at (530) 538-6837, ext. 169, (When the recording comes on, enter the extension number). ' For the pre -inspections, the property owner or authorized agent is required to meet the inspector at the construction site with two hard copies of the site plan. I have read and understand the above pre -inspection requirements. 11/01/2007 Date - Signature All of the Fire Safe Requirements are posted on the Butte County Fire Department website at http://buttefire.org/Fireprevention/protplan/protplan.html Rev'd 5/7/07 FILE Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-2140 Fax www.buttecounty.net/dds NOTICE TO BUILDERS Before your building permit can be issued, your plans must be checked for compliance with the California Building Codes. In addition, your plans are routed to other regulatory entities including but not limited to Planning, Public Works, Environmental Health, and the California Department of Forestry for their clearances and approvals. There are some things you can do to expedite your permit: 0 Make sure your application is complete. 0 Be responsive to requests from County departments for any additional materials or requirements. The Building Division places its highest priority on processing building permits as quickly as possible and each day that passes without a complete application adds to processing time. Every permit issued by the Building Official shall expire and become null and void if the work authorized by such permit is not started or completed within one year from the date of issuance of such permit. A permit may be renewed (for a fee) prior to expiration an indefinite number of times, provided construction progress has been documented by the Building Division during each year during scheduled inspections. No changes may be made in the original plans and specifications for such work. In order to reinstate action on a permit after expiration, the permittee shall pay a new full permit fee and additional plan checking and documentation may be required. Upon completion of work covered by this permit, please contact this office for final inspection. As a reminder to you, it is illegal to occupy this building or any portion of the building for which this permit is issued without a final inspection. EXPIRATION OF PERMIT APPLICATION AND REFUND POLICY Application for which a permit has not been issued will expire one year after date of application. Refunds may only be made upon written request by the person who originally paid the fees. Refunds for permit applications (not yet issued) must be requested within two years from the date of fee payment. Fees paid at the time of application are for Plan Check and administration. The Plan Check portion of fees is refundable only if the permit is cancelled or withdrawn before any plan checking is done. Building Division costs will be deducted prior to authorizing a refund and a charge of $54.99 to process the refund application will be assessed. Refunds on permits (issued) may be requested prior to the expiration of the permit, provided no work has been done pursuant to the permit. An Inspection may be required (and deducted from any refund amount) to determine no work was done. Fee/refund information can be read on-line at http://municipalcodes.lexisnexis.com/codes/butteco/ Reference Number: B07-2260 Location: 5709 FORBESTOWN RD Parcel Number: 073-340-005 Date: 11/01/2007 Owner Name: BROOKS CAROL MARIE Phone: (415) 333-3780 Description: NSF DWELLING(1270), COV(160), OPEN(57)- REPLACEMENT Signature of Applicant. Date: 11/01/2007 FILE Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-2140 Fax www.buttecounty.net/dds OWNER -BUILDER INFORMATION An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: ° If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. ° If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal ° income tax withholding, federal social security taxes, workers/ compensation insurance, disability insurance costs, and unemployment compensation contributions. There may be financial risks to you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. ° For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small business Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through thier own employees, without a license contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractor is to secure an "owner -builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board's automated telephone information system at 1-800-321 -CLSB (2752) or by accessing thier website at www.CSLB.ca.gov. PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER -BUILDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED UNTILL THE VERIFICATION IS RETURNED. OWNER BUILDER VERIFICATION PLEASE COMPLETE THIS FORM AS REQUIRED BY THE STATE OF CALIFORNIA (SENATE BILL NO. 831 EFFECTIVE JULY 1, 1980). NO BUILDING PERMIT WILL BE ISSUED UNTIL THIS VERIFICATION IS RECEIVED. 1. I PERSONALLY P0 PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF T14E PROPOSED PROPERTY IMPROVEMENT. YES R NO) 2. (HAV /HAVE NOT) SIGNED AN APPLICATION FOR A BUILDING PERMIT FOR THE PROPOSED WORK. 3. I HAVE CONTRACTED WITH THE FOLLOWING PERSON (FIRM) TO PROVIDE THE PROPOSED CONSTRUCTION: NAME ADDRESS PHONE CONTRACTORS LICENSE NO 4. 1 PLAN TO PROVIDE PORTIONS OF THE WORK, BUT I HAVE HIRED THE FOLLOWING PERSON TO COORDINATE, SUPERVISE, AND PROVIDE THE MAJOR WORK: ADDRESS CITY. PHONE CONTRACTORS LICENSE NO 5. I WILL PROVIDE SOME OF THE WORK BUT I HAVE CONTRACTED (HIRED) THE FOLLOWING PERSONS TO PROVIDE THE WORK INDICATED: NAME ADDRESS PHONE TYPE OF WORK Description: NSF DWELLING(1270), COV(160), OPEN(57)- REPLACEMENT Reference Number: B07-2260 Applicant Name: BROOKS CAROL MARIE Owner's Name: BROOKS CAI�(3�, MARIE AP # : 073-340-005 Signature of Property Owner: / Date: �/ `/ = % FOUNDATION TIAL ,,SUI L DI NG RECORD 5 i 0-13 .i .o as t PARCEL- SHEET OF SHEE ': Moo S tl y P<ia zoneUnif Dining' _ DESCRIPTION OF BUILDIN07 Double Concrete f1oor.j6isi;1 :LASS&SHAPE CONSTRUCTION STRUCTURAL EXTERIOR ROOF LIGHTING AIRC N -_ -- ROOM AND FINISH DETAIL Reinforced 2.0/�C - Light Frame Sub -Standard stucco on " Flat / Pilch Wiring eating I Coolie ROOMS Gab/e KT. Conduit farted /eoni FLOORS B I 2 FLOOR FINISH TRIM Moterio/ Grade INTERIOR Wo//s FINISH Ceilin s ARCHITECTURE Standard Sheolhing Siding Nip /q B X. I Coble Gravity Humid. A// Bed Flat_ Wood _ Above-Stondord Concrete Block Shake Shed Fixtures Wall Unit Oil Burner • Court Stories Jpecio/ B48. 1 T. 8 G WINDOWS Cut UpFew Cheap Ent. Holl Fixtures USE TYPE Brick Shinoles Dormers A— I IMA4i Xl Alai? I Tile Trim L. WolerHeoter M B.T. U. ; " = Sin /e •--9-------- FOUNDATION Adobe Shakes _ �. SON - ': Moo S tl y P<ia zoneUnif Dining' - Double Concrete f1oor.j6isi;1 Gutters Central,, -_ -- Duplex Reinforced lit r "X - PLUMBING Bed 2 Aporfinenl Brick 2"d: "X - Brick _ shingle Poor Good Bed Flat_ Wood Sub Floor Slone Shake Oil Burner • Court Piers WINDOWS Tile Fixtures Motel 'I BookCoses O H. Coemend I Tile Trim L. WolerHeoter M B.T. U. ; " Shu/Jers ' Insuloted Ceilings Steel Sash Composition Automalic Fireplace Kitchen f its I I /.,,hlI Iuenv,. I I M—l'icd Nn//s I I.Sr I I r ra, a I . I Ici__i I I Ing w,r I 1 i.Ji.. r. I c_i_ i CONSTRUCTION_ RECORD J. EFFEC. Permit ' YEAR No. For Amount Dole _ APPR. YEAR NORMAL % GOOD Remoin ' Age Life 9 Table '/o RATING (E,G',A,FP) BATF DETAIL ' e' Arch. Func. Con- Stora Space Work- Cond. Attr. Plan form. upb'd Closet hship F!' Ne. FINISH FIXTURES SHOWER Floors Wo//s PVc. Lalrohl Type Grade t. T. .D. Fiini'sh � -_ -- SPECIAL FEATURES BookCoses Built -/n Beds Venetion Blinds Shu/Jers Appraiser 61 Date Unit � NORMAL % iii `AH JJU-A SHEET OF NA NAME PRnPFRTV' 1 nr^eTtnu BUTTE COUNTY PROPERTY RECORD �i Ill C? I<n I' �, P —4n ,,-i to —D PARCEL NUMBER Book I Page I Block I Parcel Code ZONING Assessment Year 19 C-7 19 19 p 19 y 19 19 UTILITIES—SITE IMPS. Date 4-f)_6-7 40 ^13,3 65-1 f Electricity: Yes ❑ Telephone ❑ Appraiser 162 25111_ 12,_S162 1621lC 162 24 162 162' Gas: Public ❑ LPG Q None 0 Supp. Assessment Yes ❑ No 0 Yes No ❑ Yes ❑ Nog Yes Rr No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Sanitary Swr.: Public U Indiv. I Use Code 160 �y HK7` 160 1V 160j + 160 kr ; 160 160 Storm Swr.: Public E! Natural L1 Transfer Code 124 Q % 124 % 124% 124 �j(' (ego % 124 % 124 % Street: Conc.❑Asph. lY Dirt[: Gravel El Acreage 108 �•! t S' 108 5, 108 { i) 108 108 Street Lights: Yes [] No ❑ Incomplete 163 P.U. 19 163 P.U. 19 163 P.U. 19 163 P.U. 19 163 P.U. 19 163 P.U. 19 C & G: Yes L] No F] Sidewalks Yes ❑ No ❑ Building Class Bedrooms 167 168 167 168 167 Z p kC 168 Z 167 168 D a U f?s'� 7 167 768 167 168 SITE TOPOGRAPHY Baths 169 169 169 169 , 169 169 Level U Rolling M OtherQ Effective Year 170 170 170 Zp 170 { 170 170 Slopes Up❑ Down[] S -S ❑ Area of Residence 171-. 171 171 p c> 171 .,,. (�+ ?�<a. ' 171 171 At ❑ Above ❑ Below El Grade .Land Type 172 LotQHomesite `� 172 Lot❑Homesite _ 172 LotQHomesite[� 172 Lot❑Homesite 172 Lot❑FlomesiteQ 172 Lot❑Homesite❑ View Q Of: Car Shelter 173 Yes ❑ No (] 173. Yes[j No 173 Yes ❑ No [R 173 Ye's ❑ No Z 173 Yes 0 No ❑ 173 Yes ❑ No ❑ WATER Pool 174 Yes Q No ❑ 174 Yes ❑ No Rf' 174 Yes ❑ No)J 174 Yes ❑ Nog 174 Yes ❑ No ❑ 174 Yes ❑ No ❑ Quantity: Quality: Partial Complete % Complete % Complete % Complete % Complete % Complete % Complete Public ❑ Well ❑ Ditch ❑ P.P. Acct. Checked Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No [I Yes Q No 11Y es E]No ❑ Supplier -757 112, . Aerial Photo Year Topa Map' Year MARKET DATA Soil Name Index Acres Comparable 1 Comparable 2 i Comparable 3 �b ju 73, Sale Date/Price. a� zS® �lfS L 7� I�� �Srcio� PRIMARY BASE SECTION Bose.Yeor 140 -7 140 140 K9 140 d 140 140 Event Date 186 2_Z8_7_5- 186 a��� 186 Oq-71 q 186 �vj 7o_c�o 186 186 Land 109 14-7 109 a a& -o 109 (5,000 109 Zor 109 109 Avg. Soil Rating Improvements 110 110 110 /� e�� 110©� 110 110 LAND REMARKS: Trees Trees and Vines 111 — 111 111 111 111 117' ro 1Xv7 COt�tH=G171 '2 . t^ Personal Property 112 112 112 112 112 112 Keyed'By: t SECONDARY BASE SECTION Base Year 240 240 240 240 240 240 Event Date 286 286 286 286. 286 286 Land 209 209 209 209 209 209 Improvements 210 210 210 210 210 210 Trees and Vines 211 211 211 211 211 211 Dui t (- U u N T Y PROPERTY RECORD PARCEL ,NAME NUMBER 11 NAME/iU �G-'!� .) - Book Page Block Parcel 0 e Code ' C) PROPERTY LOCATION - 1Jal--� } ZONINGA ssessment Year 19 �;-� 1.51 Act 19 /� UTILITIES -SITE IMPS, Date 19 p 19 19 19 Electricity: Yes ❑ Telephone ❑ Appraiser -�-�� 40 GS -13-� - - 0-!/-q_ Gas: Public ❑ LPG [D None Ll Supp. Assessment 162 Z51 ]Ce 'f? n 162 n S ( 162 �� 162 2-f 162 162' Sanitary Swr.: public [.1 Indiv. � � Use Code Yes ❑ No ® Yes No ❑ Yes ❑ No Yes No El Yes ❑ No ❑ Yes ❑ No ❑ Storm Swr,: Public [ ! Noturol! � Transfer 160 4 V 11KY 160 V }ate 160 S + 160 160 160 Code Street: Con-. ❑Asph. � DirtL Gravel rj Acreage 124 % 124 �0 % 124 % 124 6(' (rou % 124 % 124 % Street Lights: Yes U No ❑ Incomplete lOg 163 P.U. 108 ( CJ ( 108 108 C & G: Yes (� No ❑ Building Class 19 163 P.U. 19 163 P.U. 19 163 P.U. 19 163 P.U. 19 163 P.U. 19 Sidewolksi Yes ❑ No ❑ Bedrooms 167 168 167167 Z ,O G 167 D Z U �; G 167 167 SITE TOPOGRAPHY Baths 169 168 168 Z 168 7 168 168 Level ❑ Rolling Other U Effective Year 170 169 169 169 169 169 Slopes UP EJ Down ❑ S -S ❑ Area of Residence 17} 170G 170 l ZQ 170 , �7 170 170 At El Above 11Below E) Grade Land Type 172 171 171 p U 171 (? s�.� 171 Lot[] HomesiteW 172 Lot Homesite ❑ 171 View C Of: Car Shelter 172 Lot❑Homesite[ 172 �yy-� Lot❑ Homesit4g 172 Lot❑Homesite❑ 172 Lot❑Homesite❑ WATER Pool 173 Yes ❑ No r] 173 Yes ❑ No, 173 Yes ❑ No 173 Yes ❑ No Z 173 Yes ❑ No ❑ 173 Yes ❑ No ❑ Quantity: Quality: Partial Complete 174 Yes ❑ No ❑ 174 Yes ❑ No'd' 174 Yes ❑ NoRl174 Yes ❑ No 174 ' Yes ❑ No ❑ 174 Yes ❑ No ❑ Public F1 Wei l ❑ Ditch ❑ P.P. Acct. Checked %Complete % C omplete %Complete %Complete % C:omplete %Complet Supplier Yes No ❑ E3e Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ ❑ No Yes ❑ No ❑ Yes ❑ No ❑ Aerial Photo Year s 1Z Topo Map Year Soil Name Index Acres Comparable 1 MARKET DATA 5� Comparable 2 bfi - 4' — L 5� 3 Comparable 3 Sale Date/Price PRIMARY BASE SECTION Base Year 140 -7G 140 140 99 140 140 Event Date 186 c�_- i07 Z -Z•_, J, 186 � � a 186 Oq-21 - 7 186 -,?9-j97 03_ 20-�(0 186 140 186 Avg. Soil Ratingo^�r� Land Improvements 109 14-7 109 -IL(, aS� 109 (1j o00 109 Zo 109 lOq LAND REMARKS: r1 IL✓] �c c�tz� T Trees and Vines 110 111 _r-.110 110 q 2 io 110 5 ��, 0 110 110 t'✓tlX�:%' con.ttF�st"t 7.. f:;;y._�',:�, h Personal Property 112112 — 111 11 } 111 111 111 Keyed'By: 1-1 112 112 112 SECONDARY BASE SECTION Base Year 240 240 240 240 Event Date 286 286 286 240 240 _ Land 209 286 209 286 286 • Improvements 210 209 209 210 209 209 Trees and Vines 2}} 210 210 211 210210 Keyed By: 211 211 211 211 SITE PLAN REVIEW APPLICATION Date: Permit Number (if applicable) APPLICANT INFORMATION Owners Name: Owners Address: Telephone No.: Situs Address: Proposed Use: AP# Parcel Size: Residential ❑ New Single Family Residential ❑ Single Family Addition t ❑ Mobile Home ❑ Residential Accessory ❑ Permanent Second Dwelling T❑ Temporary Mobile Home (Aunt Minnie) ❑ Temporary Travel Trailer ❑ Multi -family Non-residential ❑ New Commercial ❑ Commercial Addition ❑ New Industrial ❑ Industrial Addition Other Septic ❑ Agricultural Exempt Building ❑ Other: Brief Explanation (if necessary):_ ❑ Single Family Remodel ❑ Commercial Remodel ❑ Industrial Remodel ❑ Well ECE0VE AUG - 6 K104 BJi •• r �•rd f�,'�i ?i; avi, AKIN I,,,: . DO NOT WRITE BELOW THIS LINE DEVELOPMENT SERVICES INFORMATION (For Staff Use) [Approved ❑ Conditionally Approved ❑ Resolve Problems Prior to Approval (,Site Plan Stamped Approved* By Date ALL ITEMS'CHECKED APPLY TO THE PROPERTY Parcel Is In: ❑ Snow Load Area: J Suy -- go p L f% ❑ Land Conservation Act MinimumAT creage: ❑ Verify residence can be built per contract ❑ Nitrate Action Plan _(See Environmental Health for standards) ❑ Watershed Protection Overlay Zone (See attached standards and requirements) ❑ Expansive Soils (Test for expansive soils and if verified proper foundation design required) SRA - (CDF to determine specific requirements) ❑ 100 -Year Flood Plain: (See attached) • Flood Zone: Flood Panel No.: 0 (oO 0-7W 50 �, Index Date: q� ❑ Sacramento River Reclamation District (Approval must be obtained from the California Reclamation Board) ❑ Feather River Reclamation District (Approval must be obtained from the California Reclamation Board) ❑ North Chico Specific Plan (See Development Fees Section and attached standards and requirements) ❑ Chapman/Mulberry (See attached standards and requirements) ❑ Cohasset Area (See attached standards and requirements) ❑ Grading Zone (See attached handout) Use Requires: ❑ Use Permit ❑ Minor Use Permit ❑Administrative Permit ❑ Minor Variance ❑ Variance ---------------------------------------------- ----------------------------------------- ----------------------- ❑ Detached Building Use Form ❑ Encroachment Permit ❑ Agricultural Worker Affidavit ❑ Agricultural Acknowledgement Statement Zoning: Applicable Building Setbacks: ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. D-1 ^-r C Zoning Code Streets & Highways Fire Prevention Subdivision Map Front Side G J Side Street Rear Height Waterway IN/A N/A N/A ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. D-1 ^-r C Applicable Development Fees: Standard Fees Amount Formula ❑ Fire ❑ School* ❑ Parks/Recreation ❑ Roads ❑ Sheriff ❑ Drainage ❑ NCSP/CSA 87 ❑ Chico Urban Area — Road ❑ Thermalito Impact ❑ Other ----------------------------------------------------------------------------------------=------------------------------ Subdivision Map Special Fees ❑ Water Tender ❑ Road Improvement ❑ North Oroville Area ' ❑ Other (per map) Check with school district to verify actual fee if pre -application review. A final determination will be made at the time of the building permit. Parcel Created By ❑ Deeds: Date of Creation: Legal Access Provided: ❑ No ❑ Yes Deed of Reference: Legal Access Required ❑ No ❑ Yes Parcel Frontage on Publicly Maintained Road: ❑ No ❑ Yes, Road Name: Complies with County Standards for Deed Creation:❑ No ❑ Yes Comments: ❑ Parcel Deemed to be legal ❑ Verify Legal Parcel •❑ Verify Legal Access ❑Provide Deed of Creation ❑ Obtain a Certificate of Compliance ❑ Obtain a Merger ❑ Obtain a Lot Line Adjustment ❑ Comply with Old Subdivision Lot Ordinance (Maps recorded prior to Book 17 of Maps Page 23). ❑ Construct road to: ❑ Meet Parcel size required by zone ❑ Meet current Environmental Health Department requirements Subdivision Map/Parcel Map: Map Date of Recording: ' q Lot: vl Book: `t Page: ❑ Use Permit/Minor Use Permit Permit Number: Date of Approval: Parcel Map/Subdivision Map/Use Permit Conditions ❑ Comply with the following Conditions of Approval: ❑ Meet the Fire Safe Regulations of Butte County and P.R.C. 4290 ❑ Automatic fire suppression sprinkler systems shall be installed in accordance with the National Fire Protection Association Standard for installation of sprinkler systems in one and two family dwellings and mobile homes, NFPA Standard 13D, unless a pressurized community water system, with hydrants that meet the Fire Department specifications, serves the parcel. ❑ Wood stoves and fireplace inserts shall be EPA approved and designed to meet the emission requirements of the California Clean Air Act of 1988, as amended. ❑ Provide an erosion control plan for building and land disturbance. The Erosion Control Plan must be prepared by a registered civil engineer or other qualified professional and be submitted to and approved by the Department of Public Works. ❑ In lieu of a pressurized water system or water storage tank, payment into the appropriate Battalion Water Tender Fund may be required. ❑ Measures shall be taken to control fugitive dust emissions from all driveway and other civil construction associated with residential development: Approved dust control measures are found in the fugitive dust control plan for the site approved by the Butte County Air Quality Management District, a copy of which can be obtained from the Butte County Department of Development Services, Building Division." ❑ Engineered foundations are required. ❑ Class A roofs are required. ❑ Property owners responsible for road maintenance, and stop sign maintenance. C r___ a _cc 0 Summary of Specific Requirements: This information provided in this summary is based on the application information and on the best available data at the time of review. 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J//lab � • - RI a .A7/VO NOI.Zl 1 Ua107nJ7VJ - O C/,'Y-79-979-97 �I .I dVW NO/1VJ07 0o p ao AO+Llb O/ /7 C/m/7/, OO (�/,6021F 3.60,01 'NJl/U 'U'/ Al G dNt >O da/5 oo/ -./ a7v�s NL/709 9N1 WOd>, 0614Vd717 Z 774175 E 1 d ' / 5K07 NO BXNf L J/lda5 (6 'tvavv a'�vB'�ac aad/> o7a/>Iv�via7 aa'v Bvaav uan�l v// ([ ' 317N/Wd,�7130H.' NO/3'0/0.7 'I L e 'L'O BOCL A1!/ao'Obe' 9N/l7a!!p 41N3/Ya50d 'L/ L'd ONO 'aj '011./ (/ :SalOiV 4 August 2, 1995 Carol M. Brooks 2900 Carmel Street # C Oakland, CA 94602 Re: Letter of inquiry concerning Special Inspection and permit requirements. Dear Ms. Brooks, This is in response to your letter of inquiry dated July 10, 1995. I left a message on your answering machine July 24, 1995, and have not received a return call. I cannot determine where your property is located without a street address or an assessor's parcel number, so I cannot discuss the specifics of your property at this time. Depending on the overall condition of the building, it is possible to obtain building permits to work on any portion of a residence without bringing the entire structure up to code, but this depends on several factors which we could more easily discuss on the telephone. Should you have any questions concerning this matter, please contact Scott Rutherford or Michael Vieira of this office at the address or phone number listed above. Sincerely, Scott Rutherford ' Supervisor, Building Inspection BUILDING DEPT J U L 13 1995 July 10, 1995 Scott Rutherford Building Department 7 Country Center Drive Oroville, CA 95965 Dear Mr. Rutherford, I own an old house on a piece of property in Forbestown(Lot 4, Walden Pond Estates -_116-_ _ 98). The house needs a foundation put under it and I would like to get the required - specifications and permit applications so that I can have my contractor begin work. I spoke -to Bob on July 6, 1995 and he told me to write to- you to have a special inspection scheduled so that you could properly advise me on what will need to be done. 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